Posts Tagged ‘Medication’

It’s bad enough that doctors are over prescribing medications to young children, to read that they are also prescribing them drugs that are intended for adults makes me extremely angry. How do we allow doctors to prescribe any drug until extensive research has been conducted:

Children are being prescribed unlicensed medicines that could be causing harm, a report has warned.

The Government study is demanding an urgent investigation into the ‘unacceptable’ fact that almost a third of drugs given to sick children are officially approved for only adult use.

It warns of ‘a high number of drug errors’ in which children may be wrongly prescribed too much of a medicine because the doses are meant for adults.

Historically, pharmaceutical companies have not had an obligation to test medicines on youngsters. The law changed in 2007 and new drugs coming to market must now be tested on children before they can be used on them.

But this still means about 30 per cent of drugs prescribed to under-18s – and up to 95 per cent of drugs given to babies in intensive care – have never been tested on children.

It’s one of modern days big tragedies that doctors seem to be in bed with the big pharmaceutical companies.

Some doctors seem to relish the opportunity to prescribe psychiatric drugs. After all, from the perspective of a passive observer, prescriptions of such medication are becoming all too frequent. I wonder if it will get to the stage when those not on drugs will feel left out and marginalised because of it:

PRESCRIPTIONS of antipsychotic drugs given to children have doubled in only five years, data obtained under freedom of information laws shows.

Antidepressant prescriptions have also risen, bucking international trends to reduce the use of the drugs after they were linked to children developing suicidal thoughts.

A psychiatry professor at the University of Adelaide, Jon Jureidini, said he was concerned antidepressant medication use was increasing despite warnings about suicide risks.

He said antidepressants should almost never be used in children.

After the US drug regulator issued a warning about the risk of suicide in children and teenagers taking antidepressants, there was a 58 per cent drop in the use of the drugs.

Yet between 2007 and 2011 in Australia antidepressant prescriptions increased from nearly 22 prescriptions per 1000 children aged below 16 to nearly 27, data provided to the Herald by the Department of Human Services under freedom of information laws shows.

Last year there were about 14 antipsychotic prescriptions for every 1000 children, compared with seven in 2007.

Professor Jureidini said it was likely the increase in the prescription of antipsychotics could be explained by doctors prescribing the drugs for behavioural problems, or by conditions such as personality disorder being reclassified as bipolar disorder and then treated with antipsychotics.

”There has been a very significant increase in the prescription of antipsychotic drugs and we can be pretty confident there has not been an increase in psychosis,” he said.

Antipsychotics are recommended for the treatment of children with conditions such as bipolar disorder, in some cases. National Health and Medical Research Council guidelines say doctors can consider prescribing an antidepressant for childhood depression in the short term, where psychological therapy has not been effective or has been refused.

Professor Jureidini said more monitoring of the drugs and their side effects was needed, along with training for GPs on non-pharmacological treatments.

A clinical adviser to the National Prescribing Service, Philippa Binns, said those who were prescribing antipsychotics and antidepressants to children should be specialists in children’s psychiatric problems.

I plead to doctors worldwide to please resist from writing a prescription for drugs unless you have tried all other options which have turned out to be unsuccessful.

I find the ADHD trends highly frustrating. I am not a doctor or medical professional of any kind so it’s not for me to speculate whether or not ADHD exists. What bothers me, is the rapid increases in children being diagnosed (and more importantly, medicated) with the syndrome. To me Ritalin and other types of ADHD medication must be the last resort. It’s side-effects are often quite pronounced and sometimes quite sad to experience. Kids with larger than life personalities and great bursts of creativity can often be left following their own shadows (I have personally witnessed this!)

When I first entered into the profession I was given medical forms to fill out about a particular student. A previous teacher must have recommended that this student be assessed due to the belief that she may have some ADHD symptoms. In my view she was just a child with poor self-esteem who lacked concentration. In my assessment of her I made it clear that I felt that beyond her concentration being poor there was no other reason to suspect that she may have ADHD.

It didn’t help. Unfortunately, within weeks of being presented with this patient, the doctor prescribed her with Ritalin. No suggestions of a change of diet, no therapy to examine if there is any cause for her low self-esteem and no evidence that she was sent to have her language skills tested. Just the “go to” method, the “one pill fits all” strategy – the blasted pill!

I am proud to say that this child is now off the medication. Her parents decided it was not something they wanted her to be on permanently so they eased her off it. Doctors would be shaking their heads right now and accusing the parents of being irresponsible. But the parents were right. She is now a happy, focussed, non-medicated young teenager.

SIMPLY eating healthier may improve the behaviour of children with attention deficit hyperactivity disorder (ADHD) if therapy and medication fail, says a study published in the journal Pediatrics.

Nutritional interventions should therefore be considered an alternative or secondary approach to treating ADHD, not a first-line attack, said the review by doctors at Northwestern University Medical School in Chicago, published on Monday.

What they mean by that is first pop the pills and then consider your sugar intake. This is ridiculous. What is the big deal about investigating diet and other possible causes before, as a last resort, prescribing the medication?

I suppose it was only a matter of time. The writing was on the wall earlier this year when experts were outraged when a mother, Christie Haskel, claimed that coffee had cured her son of ADHD. The medical experts came out in force against Ms Haskel. How can this woman treat her child with something other than a drug with pharmacological effects that resemble closely those of cocaine and amphetamines? And coffee? That could damage the poor child’s health!

EXPERTS have warned that parents who don’t medicate children with ADHD could be referred to child protection authorities under controversial draft guidelines being considered by the National Health and Medical Research Council.

The practice points, to guide doctors who treat the disorder, were drawn up by an NHMRC expert working group to address community concern over the use of stimulant medication to treat attention deficit hyperactivity disorder. They state: “Consideration should be given to the ability of the child/adolescent and their caregivers to implement strategies. As with any medical intervention, the inability of parents to implement strategies may raise child protection concerns.”

Child psychiatrist and Monash University lecturer George Halasz says the situation should not be seen as unique to ADHD and parents who fail to manage serious conditions such as their child’s asthma or diabetes could also be considered to be failing their duty as a parent.

Dr Halasz said the new guidelines were a step in the right direction because they asked doctors to first try to find other explanations for a child’s behaviour before they diagnosed ADHD.

Firstly there is a gulf of difference between a parent’s decision not to administer ADHD drugs and a decision not to treat a child for asthma and diabetes. Secondly, this move does not promote trying alternate methods but reinforces what many suspect; that Ritalin and it’s type have become a one-stop fix for a condition yet to be fully proven.

The British Psychological Society said in a 1997 report that physicians and psychiatrists should not follow the American example of applying medical labels to such a wide variety of attention-related disorders: “The idea that children who don’t attend or who don’t sit still in school have a mental disorder is not entertained by most British clinicians.”

How about we report lazy doctor to the authorities who prescribe this drug without due process? How about we report bullying tactics by so-called experts? How about we let parents decide for themselves what is in the best interests of their children?

How about you think about the consequences of drugging such a large proportion of our young?

I am not a doctor, so I do not have the expertise to comment on the ADHD diagnosis becoming a regular feature of classrooms across the globe. But I can’t help but get agitated as kids younger and younger are being given these drugs. The cynic in me suspects that this has more to do with pharmaceutical profits and less to do with responsible medicine.

The recommendations, the first in a decade, expand the age range of kids who may be prescribed the drugs from preschoolers through 18-year-olds. Earlier guidelines included children ages 6 to 12. ADHD affects about 8 percent of children and youth and is the most common neurobehavioral disorder in kids, according to the American Academy of Pediatrics.

Expanding the age range will help ensure more children get the appropriate therapy, according to the guidelines. Treating preschoolers may increase their chances of succeeding in school and targeting teens recognizes that ADHD is a long-term condition that may even extend into adulthood.

“Because of greater awareness about ADHD and better ways of diagnosing and treating this disorder, more children are being helped,” said Mark Wolraich, lead author of the report and a professor of pediatrics at the University of Oklahoma College of Medicine in Oklahoma City, in a statement.

For preschoolers with the disorder, it’s recommended that parents and teachers first try to manage children with behavior therapy that uses a system of rewards and consequences. If that doesn’t work, then doctors can prescribe medications, according to the recommendations being presented today at the American Academy of Pediatrics National Conference and Exhibition in Boston.

I have three major issues with the last paragraph in particular.

1. I don’t believe you can determine such a disorder at such a young age with such confidence as to justify prescribing a Ritalin-like drug to them.

2. The idea that some “behaviour therapy” is all that is tried before a child gets a prescription is just shocking. There should be many steps before a child warrants a prescription. Prescribing drugs to a child should be the last resort. And who checks whether the behaviour therapy was properly administered? How many teachers say they have tried everything, when you know they haven’t even come close?

3. This leads me to my third point. Teachers should not have such a big say in the decision to prescribe drugs to a child. Teachers are often too easily motivated by the need to teach a civil and restrained class. Their need to see students calm and manageable often gets in the way of a more considered approach when it comes to the question of ADHD drugs.

Four year olds on ADHD drugs! Do we really want this to become the norm?

Whilst I don’t for a second advocate giving coffee to a child, I applaud Christie Haskel for trying to find an alternative to the drugs doctors prescribe. As I was watching the abc report on this mother I felt like the reporter was trying to manipulate me into thinking that this woman acted irresponsibly and recklessly by treating her child without consulting a doctor.

But I didn’t fall for the manipulation. Good on her for resisting Ritalin. She has every right to find an alternative to a drug many parents are weary of. Below are some issues I had with the reporting of this story.

1. The story quotes that “experts say there is no proof it works.”

Well actually I am of the opinion that if it works for some people, as it has worked for this mother it “can” work. No more proof required.

2. The piece lists the “potentially dangerous side-effects of caffeine.”

A meta analysis of the literature concluded that methylphenidate quickly and effectively reduces the signs and symptoms of ADHD in children under the age of 18 in the short term but found that this conclusion may be biased due to the high number of low quality clinical trials in the literature. There have been no placebo controlled trials investigating the long term effectiveness of methylphenidate beyond 4 weeks thus the long term effectiveness of methylphenidate has not been scientifically demonstrated. Serious concerns of publication bias regarding the use of methylphenidate for ADHD has also been noted. A diagnosis of ADHD must be confirmed and the benefits and risks and proper use of stimulants as well as alternative treatments should be discussed with the parent before stimulants are prescribed.

4. The question is asked how does the mother know that by solving this one problem she isn’t creating several new ones:

It was documented in 2000, by Zito “that at least 1.5% of children between the ages of two and four are medicated with stimulants, anti-depressants and anti-psychotic drugs, despite the paucity of controlled scientific trials confirming safety and long-term effects with preschool children.”

It is ludicrous to attack a mother for trying to find alternatives to a drug that comes with known side-effects, has stark similarities to cocaine and amphetamines and hasn’t convincingly proven the case against dependency or long-term side-effects.

Coffee isn’t something you’d want to be giving a child but neither is Ritalin. I know which one I would rather give my child.

Sooner or later there will be a drug for everything. No problem self-made or genetic will be without its own medication.

And we will all be worse for it.

I have a very cynical view of the pharmaceutical industry. I don’t believe what they are telling us about how they are giving children with poor concentration a quality of life they wouldn’t ordinarily have. Maybe I should buy in to it, but I don’t. Instead, I believe that they are replacing one problem with the threat of a much bigger problem. The effect of drugs on a child isn’t fully known yet. I fear that when we do have comprehensive data on the effects of drugs such as Ritalin on young children, we won’t like what we see.

The latest drug to concocted is a truancy drug. That’s right, a drug for not wanting to go to school! It is recommended that no child under 18 take it, but whoops, that rules out school aged children! Not much point making a truancy drug for adults.

It is high time we put pressure on the medical fraternity to explain their actions. I am no expert, but the increase in prescriptions of anti-depressants to kids as young as 6 seems highly irresponsible. What on earth do these kids suffer from that warrants prescribing such medication? How can we sit idly while Governments pretend to investigate the boom in child anti-depressant prescriptions, whilst quietly doing absolutely nothing to deal with the problem?

THE number of children aged six and under being prescribed anti-depressants has soared since the Federal Government pledged to investigate the matter in 2008, new figures show.

The Herald Sun can also reveal that in the past two years, the deaths of five people aged 10-19 have been linked to anti-depressants. Federal Health Department data reveal prescribing rates of the controversial drugs in children aged two to six has risen from 852 in 2007-08 to 1264 in 2009-10.

In Victoria, the number has increased from 156 to 229, and, in the past two years, in the 7-11 age group, from 825 to 1085.

The Government has refused to release details on children under two since 2007-08, claiming the figures are unreliable.

But despite Health Minister Nicola Roxon’s ordering of an investigation three years ago, a Freedom of Information request shows just two meetings were held.

The Royal Australian and New Zealand College of Psychiatrists said it was alarming that anti-depressants were being prescribed for children and demanded answers from government.

“I would be very very alarmed if these figures were true,” said Dr Phillip Brock, chairman of the Child and Adolescent Psychiatry faculty.

Australian Medical Association vice-president Dr Steve Hambleton said he had given anti-depressant scripts for two six-year-olds, and they had benefited.

A Health Department spokesman said the management of a child’s medical condition, including prescribing anti-depressants, was a doctor’s clinical decision.

The figures show Zoloft and Prozac were among the most prescribed of the drugs in the youngest age group.

Black Dog Institute director Professor Gordon Parker said while not all anti-depressants were used for depressive disorders in children, an investigation was needed to explore why they were being prescribed.

Are the Drug Companies giving substantial donations to the Government? Is the medical fraternity happy with the reputation they are getting of treating children with prescription drugs before they reach the age of being able to read or write? What’s next? Are babies going to be prescribed anti-depressants?

Emeritus Professor John Werry, a child psychiatrist, expressed another opinion – as far as he knows giving SSRI antidepressants to babies would be of no harm to them. However, he acknowledged the medications influence basic bio-cyclic processes.

America is running our of Ritalin! Parents are frantically running around trying to find pharmacies that still have some in stock. You might think that what I have just written is the making of good fiction, perhaps a Hollywood satire, but I’m afraid that it’s a true story, with potentially huge ramifications.

Nationwide shortages of popular drugs used to treat ADD and ADHD are sending parents scrambling, with some combing multiple pharmacies for the Adderall and Ritalin that keep their kids calm.

Molly Taylor, 46, of Worcester, Mass., was turned away empty-handed this week when she went to pick up prescriptions of Adderall XR for herself and her 16-year-old son, Luke.

“They don’t have them,” an incredulous Taylor told msnbc.com. “You could be waiting several days, which would have a HUGE impact. If you can’t get it that day, it’s very, very difficult.”

In the past two weeks, federal Food and Drug Administration officials added the drugs methylphenidate hydrochloride and amphetamine mixed salts, the generic names for Ritalin and Adderall, to an expanding list of national drug shortages. Some distributors cite manufacturing delays and increased demand as the reasons; others offer no explanation for the shortages.

But the American Society of Health-System Pharmacists, which tracks drug supply issues, has listed the products in short supply for nearly a month, and there have been regional reports of spotty shortages even before that.

5.4 million children have ADHD

In the United States, an estimated 5.4 million children ages 4 to 17 have ever been diagnosed with ADHD, or attention-deficit/hyperactivity disorder, and 66 percent of those with current ADHD take medication to control the condition, according to the Centers for Disease Control and Prevention.

Last year, that amounted to 152 million units sold of Adderall and Adderall XR, the extended-release version of the pill, 35 million units of Ritalin and nearly 702 million units of generic ADHD drugs, with sales totaling more than $1.2 billion, according to data from Wolters Kluwer Pharma Solutions.

For millions of children — and adults — the stimulant medications ease the symptoms of ADHD, allowing them to control distracted thoughts and behavior well enough to participate in school, work and social life.

The drugs are taken daily, but when patients miss even one dose, the consequences can be swift, said Ruth Hughes, interim chief executive of the organization CHADD, Children and Adults with Attention-Deficit/Hyperactivity Disorder.

“The symptoms come back very quickly,” said Hughes, who is the mother of an adult son with ADHD. “If you start that spiral, within 24 hours you begin to get in the loop of negative feedback. It doesn’t take very long until it has a truly negative impact.”

The current shortages affect various doses of the medications supplied by several manufacturers of brand-name and generic drugs. That means patients who find they can’t get their usual prescriptions might be able to find a similar drug in a different strength, made by a different manufacturer.

However, because the drugs are tightly controlled by the U.S. Drug Enforcement Administration, prescriptions are doled out only a month at a time, and patients have to visit their doctors in order to authorize new drugs, which could be more expensive than the old ones.

“Tightly controlled”? You have got to be kidding me! This is sickening! How can we sit and watch our kids being prescribed these drugs in the millions and not wonder whether or not these kids really have ADD and ADHD? How can you get to the point where demand for a drug for children is so readily prescribed that demand exceeds supply?

It seems like pharmaceutical companies are winning, and we are sitting there silently letting them. It is time for a parliamentary inquiry on this issue. Doctors and teachers in particular need to be accountable for their role in this situation.

Surely when a drug becomes so rampantly prescribed that drug companies struggle to meet demand, there is something not quite right going on? Or am I the only one that thinks this is the case?